A Framework for Designing and Evaluating Internet Interventions to Improve Tinnitus Care

Tinnitus can be a debilitating hearing-related symptom. Access to evidence-based tinnitus interventions remain limited. Tele-audiology can assist by providing a clinically and cost-effective tinnitus management route. This chapter highlights how this is made possible by focusing on one form of tele-audiology, namely an internet-based intervention. Guidelines are provided for the development of such interventions. A framework outlining the various processes involved in evaluating newly developed interventions is also provided. The chapter closes by discussing factors that may facilitate or hamper the dissemination of new interventions into existing service delivery models. This well-defined outline for intervention development and evaluation can be applied and used to guide innovative intervention models by stakeholders.

Empowering Cochlear Implant Users in Their Home Environment by eHealth Solutions

In the chapter, the authors address the prescient need to update accepted care models of cochlear implant (CI) fitting and long-term maintenance to better utilize self-care and tele-medicine possibilities, thus shifting the focus of CI maintenance to the recipient. There is a strong evidence base that such a move will better meet the needs of CI users, giving them greater control of and involvement in their hearing progress. Simultaneously, such an approach can better meet present shortcomings in the market acceptance and delivery of the benefit of cochlear implants, particularly in the elderly segment of the population, where device penetration of the market remains low (c. 7%). Such initiatives make it viable to reach many more users, as the present models are prohibitively expensive for such expansion. A case study of pilot software for CI maintenance based on tele-audiology is described with the inclusion of data collected from initial studies.

Goldstein and Stephens Revisited and Extended to a Telehealth Model of Hearing Aid Optimization

Tele-audiology practice is sometimes portrayed or practiced as an extension of conventional audiology practice, but in reality, it should be considered as a more flexible and innovative way of delivering hearing healthcare. It is likely to continue expanding beyond the bounds of conventional audiology into the future. This has far-reaching implications for clinical utility and client satisfaction. One important consequence is that tele-audiology is changing the way individuals are approaching their hearing health. In a connected economy, people are becoming more empowered in managing their health and are metamorphosing from patients, whose only option is to visit a clinical facility, to consumers with choices. There will still be a need for conventional audiology practices to manage more complex cases where medical diagnosis and intervention are involved, or where clients prefer face-to-face service, but this will be as part of a hearing health ecosystem where the consumer makes the choices drawing on a range of influencing factors. There is now substantial evidence from large-scale studies and clinical data that aspects of tele-audiology are prevalent within different service models and that the outcomes are at least as beneficial to the recipients as the outcomes from delivery of conventional audiology services in conventional audiology clinics. In addition to potential improvements to client outcomes, tele-audiology is already starting to improve access to hearing health services, reduce costs, and deliver social and economic benefits to society.

Emotional Factors for Teleaudiology

The internet has created new possibilities for health practitioners to deliver services remotely. The potential for telemedicine is yet to be fully realized. Many factors hamper the uptake of telemedicine, including funding models and the availability of technology. This chapter concerns one important area often neglected by technology developers: considering the emotions of users interacting with systems and services. The authors believe that consideration of emotions is essential for the advocacy, adoption, and appropriation of telemedicine services by a wide range of stakeholders, who have diverse abilities and motivations. They consider one area of telemedicine: teleaudiology. The authors outline emotional factors that need to be considered in providing teleaudiology services drawing on research from software engineering developing agent-oriented models of socio-technical systems, as well as knowledge of assistive technology frameworks. They consider how emotional factors can be taken into consideration with respect to a specific teleaudiology service provided by a successful company.

Tele-Audiology and Security Management

Security is a huge topic and not at all fun. It's hard to understand. It can be scary. It is always lurking. And poor security can bring down any system, regardless of how useful or important it is. Understanding the risks and vulnerabilities in systems and the motivations and methods of attackers is important in designing and operating secure and robust systems. This chapter aims to give a perspective on how to think about information technology (IT) security, how it applies to telehealth and audiology, and finally gives some recommendations about important considerations for tele-audiology systems that include devices, data housing, smartphone applications, and patient records.

Regulatory Issues in Telehealth

Telehealth and digital health more broadly have become two of the fastest growing IT sectors in the world. They have the potential to transform lives everywhere, often before regulation has had the chance to catch up to everyday reality in healthcare. This chapter is grounded in clinical practice occurring at the time of writing and discusses at a high level regulatory issues in telehealth. This chapter argues that complexities regarding regulation over clinical applicability, patient identification, bandwidth, and funding mechanisms, as well as data storage, jurisdiction, and usage should not prevent uptake of telehealth and digital health given the clinical benefits of telehealth in countries such as Australia and internationally.

Apps for Hearing Healthcare

This chapter provides a picture of the evolution of mobile applications (apps) for hearing health care (HHC) in terms of availability, variety, penetration, offered services, and target users. Special emphasis is given to newly developed methods that might assist audiologists and hearing professionals to get meaningful information and guidance for informed adoption of apps for themselves as well as for patients and their families. The chapter also shows how these novel methods can be used to characterize and compare a variety of apps across a wide range of services and target user groups. A representative sample of apps, assessed by using such a standardized framework, is analyzed to derive a multifaceted picture of apps for HHC. The chapter outlines and discusses emerging trends and needs in the area and highlights the open challenges as well as potential opportunities for professionals, researchers, developers, and stakeholders at large.

The Expected Benefit of Hearing Aids in Quiet as a Function of Hearing Thresholds

This chapter aimed to estimate speech perception benefits in quiet for clients with different degrees of hearing loss. The difference between aided and unaided scores on a monosyllabic word test presented binaurally was used as the measure of benefit. Retrospective data for 492 hearing aid users with four-frequency pure-tone average hearing losses (PTA) ranging from 5 dB HL to 76 dB HL in the better ear were analyzed using nonlinear regression. The mean benefit for the perception of monosyllabic words in this group of clients was 22.3% and the maximum expected benefit was 33.6% for a PTA of 52 dB HL. The expected benefit can be expressed as a reduction of the error rate by about half for isolated words and about one quarter for sentences across the full range of PTA.